Rosacea

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Definition

Rosacea (roe-ZAY-she-uh) is a common skin condition that causes redness in your face and often produces small, red, pus-filled bumps. Although rosacea can occur in anyone, it most commonly affects middle-aged women who have fair skin.

Left untreated, rosacea tends to worsen over time. Rosacea signs and symptoms may flare up for a period of weeks to months and then diminish before flaring up again. Rosacea can be mistaken for acne, an allergic reaction or other skin problems.

While there's no cure for rosacea, treatments can control and reduce the signs and symptoms. If you experience persistent redness of your face, see your doctor for a diagnosis and proper treatment.

Complications

In severe and rare cases, the oil glands (sebaceous glands) in your nose and sometimes your cheeks become enlarged, resulting in a buildup of tissue on and around your nose — a condition called rhinophyma (ri-no-FI-muh). This complication is much more common in men and develops slowly over a period of years.

Preparing for your appointment

You're likely to start by seeing your family doctor or a general practitioner. However, in many cases when you call to set up an appointment, you may be referred to a skin disease specialist (dermatologist).

It's a good idea to prepare for your appointment. Here's some information to help you.

What you can doPreparing a list of questions will help you make the most of your appointment time. For rosacea, some basic questions to ask your doctor include:

What might be causing the signs and symptoms?

Do I need tests to confirm the diagnosis?

What is the best treatment?

Is this condition temporary or chronic?

Is there a generic alternative to the medicine you're prescribing?

I have other medical problems; how can I manage them together?

Can I wait to see if the condition resolves on its own?

What are the alternatives to the approach that you're suggesting?

What skin care routines do you recommend I use?

Don't hesitate to ask any other questions that come up during your appointment.

What to expect from your doctorYour doctor is likely to ask you several questions, including:

Tests and diagnosis

There's no specific test for rosacea. Instead, doctors rely on the history of your symptoms and a physical examination of your skin. In some cases, your doctor may need to rule out other conditions, such as other forms of acne, psoriasis, various forms of eczema or lupus, which can sometimes cause similar signs and symptoms.

Treatments and drugs

Although there's no cure for rosacea, treatments can control and reduce the signs and symptoms. Most often this requires a combination of prescription treatments and certain lifestyle changes on your part.

MedicationsPrescription drugs used for rosacea may include:

Antibiotics. The antibiotics used for rosacea also have anti-inflammation effects. They may come in the form of creams, gels or lotions to spread on the affected skin or in pills that you swallow. Antibiotic pills are generally more effective in the short term, but they can also cause more side effects.

Acne drugs. If antibiotics don't work, your doctor might suggest trying isotretinoin (Amnesteem, Claravis, others). This powerful drug is most commonly used for severe cystic acne, but it also often helps clear up acne-like lesions of rosacea. Don't use this drug during pregnancy as it can cause serious birth defects.

The duration of your treatment depends on the type and severity of your symptoms, but typically you'll notice an improvement within one to two months. Because symptoms may recur if you stop taking medications, long-term regular treatment is often necessary.

Surgical and other proceduresEnlarged blood vessels, some redness and changes due to rhinophyma often become permanent. In these cases, surgical methods, such as laser surgery and electrosurgery, may reduce the visibility of blood vessels, remove tissue buildup around your nose and generally improve your appearance.

Lifestyle and home remedies

One of the most important things you can do if you have rosacea is to minimize your exposure to anything that causes a flare-up. Find out what factors affect you so that you can avoid them. Other suggestions to prevent flare-ups include:

Wear broad-spectrum sunscreen with an SPF of 30 or higher

Protect your face in the winter with a scarf or ski mask

Avoid irritating your facial skin by rubbing or touching it too much

Wash problem areas with a gentle cleanser (Dove, Cetaphil)

Avoid facial products that contain alcohol or other skin irritants

If you wear makeup, consider using green-tinted foundation creams and powders because they're designed to counter skin redness.

Alternative medicine

Many alternative therapies — including colloidal silver, emu oil, laurelwood, oregano oil and vitamin K — have been touted as possible ways to treat rosacea. However, there's no conclusive evidence that any of these alternative therapies are effective.

If you're considering dietary supplements or other alternative therapies to treat rosacea, consult your doctor. He or she can help you weigh the pros and cons of specific alternative therapies.

Coping and support

Rosacea can be distressing. You might feel embarrassed or anxious about your symptoms and become withdrawn or self-conscious. You may be frustrated or upset by other people's reactions. Talking to a counselor about these feelings can be helpful.

A rosacea support group, either in person or online, can connect you with others facing the same types of problems — which can be especially comforting.